Depressive Symptoms in Bariatric Surgery Patients with Multiple Sclerosis
Bariatric surgery has been shown to be a safe and effective intervention for patients with comorbid obesity and multiple sclerosis (MS); however, this sub-population may be at heightened risk for pre- and postoperative depressive symptoms.
This current exploratory study aims to describe the prevalence and nature of depressive symptoms in a sample of patients with MS who undergo bariatric surgery.
Medical records were retrospectively reviewed to identify patients who received bariatric surgery and had a diagnosis of MS (n = 31) and a control sample of non-surgical MS patients with severe obesity (n = 828). Longitudinal outcome measures included the Patient Health Questionnaire-9 (PHQ-9) and Multiple Sclerosis Performance Scale (MSPS).
There were no significant differences in PHQ-9 total and item scores between groups at baseline. PHQ-9 scores significantly improved at years 1 (p < 0.01) and 2 (p = 0.03) post-bariatric surgery when compared to non-surgical controls. Higher BMI (p = 0.03) and worse overall quality of life (p < 0.01) were associated with worsening of PHQ-9 scores in the bariatric group. When compared to controls, the bariatric group demonstrated improved MSPS scores on a trend level 1 year post-surgery (p = 0.08).
Consistent with the literature on more general bariatric surgery populations, current findings highlight the possible early benefits of bariatric surgery for reducing depressive symptoms in this population when compared to controls. Importantly, results should be viewed as preliminary and additional research is needed to examine bariatric surgery and associations with depressive symptoms and performance in the MS population.
KeywordsDepressive symptoms Bariatric surgery Multiple sclerosis Quality of life Outcomes
We acknowledge the Knowledge Program Data Registry of Cleveland Clinic, Cleveland, OH, for providing the data used in these analyses. We would also like to acknowledge Nicolas Thompson and Cleveland Clinic E-Research for helping to obtain data used in these analyses.
This project was supported by the Cleveland Clinic Neurological Institute Center for Outcomes Research and Evaluation (NI-CORE) Statistical Support grant. This support was made possible due to the generous contributions made by the Wuliger Foundation.
Compliance with Ethical Standards
Conflict of Interest
Dr. Sullivan reports personal fees from Novartis Pharmaceuticals, National MS Society, and MS Cure Fund. Drs. Fisher, Heinberg, Lapin, and Aminian declare that they have no conflict of interest.
Statement of Human and Animal Rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
Informed Consent Statement
The Institutional Review Board (IRB) approval for this study was obtained by the authors and waived the need for informed consent.
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